The growth of psychopharmacology in the 1990s: evidence-based practice or irrational exuberance

The rapid growth in sales of psychotropic medications during the late 1980s and 1990s, eventually reaching $20 billion/year, reflected the increased use of seritonin reuptake inhibitors for depression and atypical antipsychotics for schizophrenia. Recently, however, some of the therapeutic claims for these medications have been challenged, and under-appreciated risks have turned out to be significant liabilities. Drug manufacturers increasingly dominate clinical trials research and evidence suggests that study designs and data presentations have been slanted to show products in a favorable light while unfavorable data were suppressed. At the same time, during the 1990s, potentially independent voices did not effectively or consistently present countervailing views. The extensive financial ties between the pharmaceutical industry and academic researchers, professional associations, and consumer groups may also have discouraged expression of critical views. Additionally, the narrow legal mandate of the FDA to evaluate the safety and efficacy of new drugs only in comparison to placebo (rather than in comparison to other treatments) probably limited its contribution. In the absence of reliable, impartial research on the risk and benefits of psychotropic medications, both before and after they are brought to market, pharmacy benefits management cannot achieve its goal of maximizing health care benefits per dollar spent. Further institutional support is needed for independent research, either conducted or funded by the federal government.     

Race and Juvenile Incarceration: A Propensity Score Matching Examination

Disproportionate minority contact is an important issue in contemporary juvenile justice. Few studies have directly examined the link between race and judicial decision to incarceration. Using official data from Pennsylvania (n?=?41,561), this study added to this literature in two ways. This study used propensity score matching to obtain a purer estimate of the influence race has on the decision to petition a case to juvenile court. The results indicated that prosecutors use perceptual shorthand in making this decision that hinges on race. Specifically, blacks were more 1.28 times more likely than whites to have their case petitioned to juvenile court.     

Alternative sanctions: myth and reality

For this study the author has reviewed 134 documents from 12 western countries: the US, Canada, Australia, New Zealand, England, Scotland, Sweden, Finland, Norway, Germany, Austria and France. The documents include the research literature as found in the RDC documentation department and documents obtained by writing to official authorities.     

Police and HIV/AIDS: The risk, the reality, the response

Risk and fear have been examined empirically and theoretically in the policing literature. To date, however, there has been minimal effort to examine these concepts in the context of HIV/AIDS. Since the HIV/AIDS epidemic was first detected nearly 20 years ago, relatively little attention has been given to the complex issues it presents for police officers. The following discussion draws from both the policing and epidemiological literatures to examine police officers’ fear and risk of occupational HIV transmission and individual and departmental responses to this fear. Important elements of educational programs and policies are also addressed.     

The effect of imprisonment on recommitment: an analysis using exact,coarsened exact,and radius matching with the propensity score

Objectives

This study examines the effect of prison versus community sanctions on recommitment to prison and compares two levels of community supervision, community control (house arrest) and probation, evaluating whether the findings are contingent on the type of matching methods used in the analysis.

Methods

Logistic regression was conducted on unmatched and matched samples. Exact, coarsened exact, and radius-matching procedures were used to create a selection on observables design. Matching variables included current offense, demographics, criminal history, supervision violations, and a rich set of Florida Sentencing Guidelines information culled from an official scoring sheet. Florida judges use this instrument to sentence offenders within the framework of the state determinate sentencing system.

Results

The results show that with exact matching, there is no effect of imprisonment on recommitment, while the other procedures suggest a specific deterrent effect of imprisonment. All four analysis methods showed that offenders under community control are more likely to reoffend than those under normal probation. Analyses between the matched and unmatched prison observations demonstrate that the matched set of prisoners is composed of offenders who have less extensive criminal records and less serious conviction offenses than unmatched offenders regardless of the matching algorithm.

Conclusions

Contrary to a prior analysis of these data, which found a criminogenic effect of prison, a null effect was found using exact matching. Comparing the matching procedures, the more precise the match the less likely there was an effect of prison. However, community control was criminogenic regardless of the matching procedure.

     

Propensity to support prison gangs: its relationship to gang membership,victimisation, aggression and other disruptive behaviours

Propensity to support prison gangs and its association with aggression, victimisation and disruptive behaviour is explored. The sample comprised 423 adult male prisoners from three Canadian prisons. Participants completed the PGB (Propensity to support Gang-related Behaviour scale) and DIPC-R (Direct and Indirect Prisoner behaviour Checklist-Revised). The former indicated gang membership propensity and included a direct question on whether or not participants considered themselves a gang member. It was hypothesised that prison-based aggression would be predicted by a propensity to support prison gangs and by gang membership. It was also hypothesised that aggression and disruptive behaviours would be reported more frequently by gang members than non-gang members. Propensity to support prison gangs was associated with aggression and other disruptive behaviours, as was actual gang membership. Aggression and other disruptive behaviours were reported more frequently by gang members. Prisoners reporting both aggression perpetration and victimisation simultaneously (i.e. ‘perpetrator/victims’) were over-represented as gang members. Gang membership did not appear to protect against being victimised. Propensity to support prison gangs was composed of beliefs that gangs were supportive, well-ordered and protective, and comprised of friends. The importance of accounting for propensity to support prison gangs and not just self-reported gang membership is discussed.     

Public participation in health planning agencies: promise and practice

Federal legislation provided an opportunity for health planning to "catch up" with the expanding citizen participation movements of recent years. Although the literature on health planning is mounting, there as yet has been no comprehensive, systematic effort to inventory the status of participation on a national scale. This note reports on a national study of Health Systems Agencies designed to inventory the participation objectives and methods in use, identify major participants and obstacles, and analyze impacts and factors influencing practice in the field. Among the findings are that agencies have favored "safe" participation methods that satisfy minimum federal requirements and provide information and public relations without transfer of power to consumers; and have broadened the base of participation in planning without mobilizing consumers or reducing the dominance of providers, who remain the most active, organized, and influential participants.     

Race and Ethnicity Effects in Federal Sentencing: A Propensity Score Analysis

Research has examined the role of race and ethnicity in the punishment of offenders. Narrative and meta-analytic reviews have indicated that race/ethnicity influences key sentencing outcomes, at least under certain conditions. This research relies almost exclusively on regression-based analyses for determining race and ethnicity effects. While this technique is useful, recent statistical advances may provide more accurate race/ethnicity estimates. The current study employs propensity score analysis to compare punishment outcomes across White, Black, and Hispanic offenders sentenced in US federal courts during the years 2006 through 2008. Results suggest that (a) during the in/out decision the effect of minority status is frequently smaller than that estimated by regression modeling and (b) during the sentence length decision the effect of minority status is frequently larger than that estimated by regression modeling. Consequently, the modeling strategy may produce different conclusions regarding the presence of race- and ethnic-based disparity in sentencing outcomes.     

Propensity for Violence among Homeless and Runaway Adolescents: An Event History Analysis*

Little is known about the prevalence of violent behaviors among homeless and runaway adolescents or the specific behavioral factors that influence violent behaviors across time. In this longitudinal study of 300 homeless and runaway adolescents aged 16-19 years at baseline, we use event history analysis to assess the factors associated with acts of violence over three years, controlling for individual propensities and time-varying behaviors. The results indicate that females, non-minorities, and non-heterosexuals were less likely to engage in violence across time. Those who met criteria for substance abuse disorders (i.e. alcohol abuse, alcohol dependence, drug abuse) were more likely to engage in violence. A history of caretaker abuse was associated with violent behaviors, as were street survival strategies such as selling drugs, participating in gang activity, and associating with deviant peers. Simply having spent time directly on the streets at any specific time point also increased the likelihood for violence.     

The prisoner's dilemma: Theory and reality

The prisoner's dilemma has become the classic example of a situation in which the process of cooperation itself produces incentives to not cooperate. An implication of the dilemma is that the prosecutor can obtain leverage in cases involving codefendants not available in other cases, by exchanging a prospect of reduction in sentence by way of plea bargaining in return for information or testimony against other codefendants. The prisoner's dilemma is described, previous analyses of the dilemma are reviewed, and then the implication stated above is tested against available data. For a cohort of defendants in robbery cases, it is found that neither the plea rate, conviction rate, nor incarceration rate is significantly higher in cases involving codefendants than in other cases.     

Satanism: Myth and reality in a contemporary moral panic

In the last decade, there have been many allegations about the prevalence of occult or Satanic criminality, which is believed to be involved in many offenses ranging from vandalism to child abuse and serial murder. Some have advocated the creation of specialized police units to combat the supposed threat. On the other hand, most of the alleged evils are very poorly substantiated, and highly questionable statements have been widely circulated. In fact, the current concern about the occult appears to have all the hallmarks of a classic moral panic, where a peripheral issue is suddenly perceived as a major social menace. This paper discusses the limited foundation of truth underlying the present crime-wave; and suggests that the panic reflects the moral and political agenda of extremists from the fundamentalist religious Right. *** DIRECT SUPPORT *** AW502017 00005